ISSUES RELATED TO HUMAN SERVICES
This section addresses the ways in which a municipality serves its citizens directly, ensuring that their basic needs are met, that they are able to live productively and with dignity, and that there are social safety nets in place to catch them when their own networks collapse. In the broadest terms, these issues can be broadly grouped into six sub-topics: elder care, healthcare, childcare, education, indigence and crime. Each will be briefly summarized below.
Elder care:Modern medicine is allowing people to live longer, more productive lives, but it is doing so at a time when increased mobility means that many elderly people no longer live with or near family when the time comes that they require assisted living or full-time nursing services. In a perverse twist on the expected laws of supply and demand, long-term elder care costs are skyrocketing at the same time that demand is swelling as the baby boom generation reaches retirement age. Federal and state safety nets for the ill and elderly may be difficult for needy people to access or understand, and they may involve the complete distribution of an individual’s assets before they may be used. Fundamental issues for municipal managers hinge on ensuring that the elderly are able to access services and resources available to them, while also providing an infrastructure that allows for adequate housing and healthcare at a point when individuals are no longer able to care for themselves, and may not have family members who can assume a prominent role in delivering or providing such care.
Healthcare:The current business and regulatory model for providing healthcare in the United States has resulted in increasing costs, increasing restriction, and a decreasing sense of confidence in the services provided to our citizens, or their availability in the event of an emergency. Debate is ongoing about how to address this on a nationwide basis, but until radical
changes occur, municipal managers will be faced with a model that results in poor people using ambulances as taxis and emergency rooms for routine healthcare needs, simply because they have no other way to access physicians and practitioners. At the other end of the spectrum, the wealthier, employed resident of a municipality may use their healthcare insurance to seek care and treatment elsewhere, if they perceive the local healthcare infrastructure to be insufficient to meet their needs. Municipal managers must work with providers, hospitals and insurance companies to find a balance and craft an infrastructure that meets needs across the full economic spectrum, while also addressing environmental (e.g. pollution, sanitation) and social (e.g. drugs, gun violence) issues that can exacerbate healthcare needs and costs.
Childcare:Since 1996, when President Clinton “ended welfare as we know it,” provision of government funding for needy families has been term-limited and predicated on an assumption that the recipient of funding would eventually return to the workforce and be weaned from subsidized support. They fallacy in this model is that many of the recipients of funding under the Temporary Assistance for Needy Families (TANF) are often single mothers with young children, and in order for them to return to the workforce, they not only have to make enough money to feed and house their families, but they must also make enough money to acquire childcare services for their children, either full day for younger children, or after school programs for school age children. As with elder care, increasing mobility means that many young families are raising their children without the safety net provided by extended family.
Lack of adequate childcare may result in people being unable to accept otherwise good jobs, children been left unattended in the home or on the street, or children being cared for in substandard, unlicensed, home-based day care centers. Ultimately, this spiral can result in indigence, with both parents and children out of their homes because they consider sheltered care to be more economically and personally acceptable to supporting the integrity of the family unit as a whole. Quality childcare services also obviously benefit the young people who receive them, reducing opportunities for unsupervised access to drugs, street violence and crime, and increasing learning opportunities in conjunction with school. Municipal managers must ensure that an adequate stock of quality, licensed childcare exists in order to maximize the utility of their working-age residents, and reduce risk and hazard to their youngest residents.
Education:One of the most complex and puzzling questions regarding education in the United States today is explaining why we spend so much per student on national, state and local levels when compared to other countries, but reap such relatively low returns for our investment
in terms of the quality of the education being provided, and its utility as students grow up and enter the working world. Primary and secondary education is a cornerstone to the socialization of our children, especially as dual-income families reduce the amount of time that children spend being socialized and educated directly by their parents. Municipal managers have a responsibility to work within their local governance and taxation models, and within the increasingly complex tangle of state and federal educational regulations and funding streams, to ensure that children have adequate and safe educational facilities and services provided and accessible. Quality education can run hand-in-hand with childcare in minimizing opportunities for criminal behavior, and reducing the likelihood of indigence now and in the future, as children are properly cared for throughout the day while their parents are working.
Indigence:Homelessness may be a symptom of a wide syndrome of societal failings and service breakdowns. It may be the result of immigration, as citizens or aliens are drawn to a municipality in the hopes of bettering their lives, only to find inadequate housing, social services
or employment opportunities. It may be the result of failures in the healthcare system, where untreated, mentally ill individuals simply can not function well enough in society to secure and hold jobs or housing. As noted above, it may be the result of a breakdown in the education and
childcare systems, as parents are unable or unwilling to abandon their children for eight hours a day to work, instead choosing to go into shelters or onto the streets with them. It may even stem from failures in the elder care system, as the infirm and aged see their fixed, finite assets consumed, but do not have the social networks available to ensure they successfully transition into subsidized housing or healthcare situations. Indigence is a direct contributor to criminal activity, both in terms of violence between and against homeless people, and in terms of petty, property or violent crime committed by individuals who see no legal means of addressing their circumstances. Municipal managers must ably work through all of these systems to build safety nets to ensure that the number of people falling out of the system and onto the streets is minimized. They must also ensure that their municipalities have the means of dealing with indigence, rather than leaving their weakest and most defenseless residents on the streets to die.
Crime:Like indigence, crime may be more of a symptom of deeper social ills than a primary phenomenon of its own. While every municipality will have its share of psychotic sociopaths, for whom violent crime is a “hardwired” activity that doesn’t require any outside provocation or motive, the majority of criminal activities with which managers are likely to contend will be driven by factors such as deteriorating housing stock, crushing economic need, unsupervised youth, drug and alcohol addition, or simply a lack of proper socialization into the
expected norms and standards of the community. The challenges for municipal managers are to find a proper balance between policing and punishing offenders, and to address the underlying issues that increase the likelihood that criminal behavior will occur. It is crucial that criminals be
held accountable for their actions, but it is also crucial that they have the opportunity to be rehabilitated and returned productively to society, if possible. (Obviously, capital and other habitual offenders with pathological tendencies may never be candidates for such rehabilitation).
Violence and property crimes may well be two of the most significant contributors to urban flight, as they have impact well beyond the actual effects of the crimes themselves. Once people become fearful that they, their families or their belongings are at risk, then no amount of positive experience in other aspects of their municipal lives is likely to carry more weight as they make their decisions to stay or leave.
In summary of the human services section, in the broadest terms, municipal managers have a very real responsibility for adequately marshalling resources to ensure that their residents have fair and equal opportunities to embrace the rights afforded to them by our federal and state constitutions. Municipal managers must recognize that their policies will impact people across the full spectrum of human experience, from the very young to the very old, from the very rich to the very poor, from longstanding members of the community to the very newest arrivals. By ensuring that these basic human needs are met, municipal managers invigorate and engage their most valuable assets—their residents—as they work to address the capital and natural resource issues discussed in the sections that follow.